National programmes: NTEP, rifampicin resistance: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · National programmes: NTEP, rifampicin resistance

Sample item

A newly diagnosed adult with pulmonary tuberculosis has a CBNAAT result of Mycobacterium tuberculosis detected with rifampicin resistance detected. What is the appropriate management under the National TB Elimination Programme?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Manage as rifampicin-resistant TB with a drug-resistant regimen through a drug-resistant TB centre

Rifampicin resistance on a molecular test marks the patient as rifampicin-resistant TB, managed as MDR/RR-TB. Further drug susceptibility testing guides the regimen and treatment is started at a drug-resistant TB centre. First-line drugs alone risk amplifying resistance.

Option by option

  • A. Start the standard 2HRZE/4HR regimen and repeat CBNAAT at 2 months

    Standard first-line therapy lacks rifampicin activity and would be ineffective and amplify resistance.

  • B. Treat as a false-positive result and repeat sputum smear before any treatment

    Delaying treatment is wrong, as a rifampicin-resistance result must be acted on.

  • C. Manage as rifampicin-resistant TB with a drug-resistant regimen through a drug-resistant TB centre (correct)

    Correct. Rifampicin resistance requires a drug-resistant regimen, not first-line therapy.

  • D. Add streptomycin to the first-line regimen

    Adding a single drug to a failing regimen is poor practice and risks more resistance.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this PSM question

What is the answer to this PSM question?

The best answer is C, Manage as rifampicin-resistant TB with a drug-resistant regimen through a drug-resistant TB centre. Rifampicin resistance on a molecular test marks the patient as rifampicin-resistant TB, managed as MDR/RR-TB.

Why is "Start the standard 2HRZE/4HR regimen and repeat CBNAAT at 2 months" not the answer?

Standard first-line therapy lacks rifampicin activity and would be ineffective and amplify resistance.

Why is "Treat as a false-positive result and repeat sputum smear before any t…" not the answer?

Delaying treatment is wrong, as a rifampicin-resistance result must be acted on.

Why is "Add streptomycin to the first-line regimen" not the answer?

Adding a single drug to a failing regimen is poor practice and risks more resistance.

What concept does this question test?

It tests National programmes: NTEP, rifampicin resistance in PSM. Further drug susceptibility testing guides the regimen and treatment is started at a drug-resistant TB centre. First-line drugs alone risk amplifying resistance.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study National programmes: NTEP, rifampicin resistance?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.